Presentation
Delivery 2 days ago. Headache with seizures. Postpartum eclampsia.
Patient Data
There are symmetrical T2 & FLAIR hyperintense signals in bilateral parieto-occipital lobes and bilateral high frontal lobes involving cortex and juxtacortical white matter with focal areas of facilitated diffusion. No blooming. No mass effect.
MR venogram showed normal appearance of dural venous sinuses.
These features are consistent with posterior reversible encephalopathy syndrome (PRES).
Case Discussion
PRES manifests as reversible vasogenic edema, predominantly involving parieto-occipital lobes. Frontotemporal lobes and cerebellar hemispheres can also be involved. It can occur at atypical sites like the basal ganglia and brainstem. It may also be asymmetrical in distribution.
It is important to rule out ischemic stroke and dural venous sinus thrombosis.
Another differential is reversible cerebral vasoconstriction syndrome.
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